title: [Geriatric assessment and factors associated with mortality in elderly patients with heart failure admitted to an acute geriatric unit].
abstract: OBJECTIVE
  Heart failure (HF) is very prevalent in older adults, and is associated with a high mortality. The prediction of the outcome of HF and the identification of patients in advanced stages is difficult. The present work aims at identifying variables of the geriatric assessment and other clinical variables associated with an increased risk of death at one year in older adults with HF.
  
  
  METHODS
  Prospective study of 101 patients (mean age, 85.9 ± 6.3 years, 81% women) admitted during 2006 to an Acute Geriatric Unit, with principal diagnosis of HF. We recorded: demographic data, predisposing heart disease, main trigger of exacerbation, comorbidity, number of prescriptions at discharge and specific treatment of HF, average length-of-stay, readmissions, and mortality at one year after discharge. Geriatric assessment included: disability in basic (Barthel index) and instrumental (Lawton index) activities of daily living, cognitive function (Pfeiffer test), comorbidity (Charlson index), and geriatric syndromes.
  
  
  RESULTS
  In a multivariable logistic regression model, previous disability (lower Barthel index) (OR [95%CI]=1.03 [1.01-1.06]; P=.040) and higher number of re-admissions (OR [95%CI]=3.53 [1.19-10.44]; P=.023) were associated with 1-year mortality. Female sex had a protective effect (OR [95%CI]=0.15 [0.04-0.59]; P=.007).
  
  
  CONCLUSIONS
  Disability in the basic activities of daily living and re-admissions were associated with increased 1-year mortality in older adults, whereas female sex was protective. If confirmed in further studies, these data could reinforce the need for a systematic comprehensive geriatric assessment in older adults with HF.
authors.affiliation: Servicio de Geriatría, Parc Sanitari Pere Virgili, Barcelona, España. Electronic address: troig@perevirgili.catsalut.net.
authors.forename: Thaïs
authors.initials: T
authors.lastname: Roig
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Márquez
authors.forename: Esmeralda
authors.initials: E
authors.lastname: Hernández
authors.forename: Ingrid
authors.initials: I
authors.lastname: Pineda
authors.forename: Olga
authors.initials: O
authors.lastname: Sabartés
authors.forename: Ramón
authors.initials: R
authors.lastname: Miralles
authors.forename: Marco
authors.initials: M
authors.lastname: Inzitari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006333:Heart Failure / Q000401:mortality*; D006757:Hospital Units; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors
keywords: Anciano; Elderly; Geriatric assessment; Heart failure; Insuficiencia cardíaca; Mortalidad; Mortality; Valoración geriátrica integral